Provider Demographics
NPI:1992194013
Name:MESSENGER, KORINDA (CNM)
Entity Type:Individual
Prefix:
First Name:KORINDA
Middle Name:
Last Name:MESSENGER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FOOTE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-6800
Mailing Address - Country:US
Mailing Address - Phone:716-484-9194
Mailing Address - Fax:716-484-0115
Practice Address - Street 1:400 FOOTE AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-6800
Practice Address - Country:US
Practice Address - Phone:716-484-9194
Practice Address - Fax:716-484-0115
Is Sole Proprietor?:No
Enumeration Date:2015-01-13
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP95726367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife